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Related Concept Videos

Imaging Studies for Cardiovascular System II:Types of Echocardiography01:20

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Echocardiography plays a role in assessing cardiac health and detecting heart conditions, with various types providing critical insights for diagnosis and treatment.
Types of Echocardiography
Transthoracic Echocardiography (TTE)
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Imaging Studies for Cardiovascular System I:Echocardiography01:17

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Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
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Comparison of two echocardiography-based methods for evaluating pediatric left ventricular diastolic dysfunction.

Xue Xiang1, Xu Zhu1, Min Zheng1

  • 1Department of Ultrasound, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.

Frontiers in Pediatrics
|September 21, 2023
PubMed
Summary

The Z value-based criteria may identify left ventricular diastolic dysfunction (LVDD) earlier in children with heart failure (HF) and high-risk HF compared to guideline recommendations. This approach aids in timely treatment interventions for pediatric cardiovascular health.

Keywords:
Z valuechildrenheart failureleft ventricular diastolic dysfunctionleft ventricular diastolic function

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Area of Science:

  • Pediatric Cardiology
  • Echocardiography
  • Cardiovascular Imaging

Background:

  • Left ventricular diastolic function (LVDF) assessment in children is crucial for managing heart failure (HF).
  • Current guidelines from the American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI) provide a framework for LVDF evaluation.
  • Alternative methods, such as body surface area (BSA)-transformed Z value cut-offs, are being explored for improved diagnostic accuracy.

Purpose of the Study:

  • To compare the consistency of LVDF assessment between the 2016 ASE/EACVI guideline recommendations and BSA-transformed Z value cut-offs in pediatric populations.
  • To evaluate the diagnostic performance of these two criteria in children with established heart failure and those at high or low risk of HF.

Main Methods:

  • Echocardiographic parameters including mitral annular e' velocity, lateral E/e' ratio, left atrial volume index, and peak tricuspid regurgitation velocity were measured.
  • LVDF was assessed using both the 2016 ASE/EACVI guideline criteria and BSA-transformed Z value cut-offs.
  • Consistency and differences between the two criteria were analyzed in cohorts of children with HF, high-risk HF, and low-risk HF.

Main Results:

  • Moderate consistency was observed between the two criteria for evaluating LVDF in children with HF (kappa=0.566) and high-risk HF (kappa=0.468).
  • The Z value-based criteria identified a higher positivity rate for left ventricular diastolic dysfunction (LVDD) in HF (23.5%) and high-risk HF (8.5%) groups compared to guideline criteria (15.6% and 3.2%, respectively).
  • Moderate consistency was also found in grading LVDD severity (kappa=0.522), with Z value criteria indicating more severe LVDD.

Conclusions:

  • The BSA-transformed Z value-based criteria may offer enhanced sensitivity for early detection of LVDD in pediatric HF and high-risk HF populations.
  • This approach holds potential for facilitating earlier therapeutic interventions in children with diastolic dysfunction.
  • Further research may refine the application of Z value-based criteria for pediatric LVDF assessment.